1Disease names (chicken and lips)?
Varicella (chickenpox)
Herpes Zoster (shingles)
2What type of infection is chicken pox/shingles?
viral skin infection--> latent sensory neuron infection
4Herpes Zoster aka
Shingles
5Shingles aka
Herpes Zoster
6Chicken pox aka
Varicella
7What are the two possible causative agent?
*Varicella-zoster virus (VCV)
*Human herpesvirus 3 (HHV-3)
8Classification of Varicella and Herpes Zoster?
*enveloped
*genome double stranded DNA
*produces latent infections
*targets sensory neurons
9Epidemiology?
*R: human
*POI: respiratory systsem
MOT: aerosol, mother to fetus
10Incubation period?
10-21 days (2-3 wks)
11Pathogenesis? pt 1
*Virus enters and replicates in the respiratory tract and spreads to lymph nodes, blood stream, and skin
12Pathogenesis? pt 2
*Viral replication in skin results in vesicular lesions that spread to sensory neurons
13Pathogenesis? pt 3
Viral genome enters nucleus in dorsal root ganglion and remains dormant
14Where does the viral genome reside (dormant)?
*nucleus in dorsal root root ganlion
15When does replication of latent virus occur?
*resumes in adulthood and produces skin rash in regions of nerve fiber innervation
16Symptoms:
*fever
*fatigue
*vesicular rash (3-4 dys)
17Duration of the vesicular rash?
3-4 dys
18Appearance of the vesicular rash, and duration?
*3-4 dys
*primarly face, throat, lower back
*less frequent in chest and shoulders
*vesicles fill with pus, rupture, and form scabs
19When does shingles occur? What type of infection is this?
*after age 50
*latent infection
*localized to skin innervated by infected senory neurons
20Symptoms of Shingles?
*hypersensitivity
*pain
*vesicular rash
21Complications of chickenpox/shingles?
*secondary infections
*pneumonia
*Reyes syndrome (leads to swelling of brain and liver)
22Main complications: and explain incidence
*encephalitis
*pneumonia
*mortaility rare for varicella
*shingles (incidence 1 and 3)
23Other complications?
*necrosis
*persistent hypersentivitiy (lasts months)
*posttherpetic neuralgia (burning or stinging)
*chronic pain (indefinite)
*Ramsay Hunt (face nerves paralysis)
25What two vaccines are used for prevention? be specific with names and dosing
*Varicella (MMRV) first dose 12-15 months, booster 4-6 yrs
*Zoster (50-90% effective), shingrix after age 50, need two doses 2-6 months apart
26Treatment for Chicken pox/shingles? (the three A's)
*acyclovir
*antihistamine
*analgesics